The terrible cough you can’t seem to kick

Allergies & ENT

by Dr. Lindsey Arviso

Mar 7, 2016

Cough, cough, cough.

Sorry, are you sick? Nope, that’s just your pesky cough that has been lingering around since the upper respiratory infection you had over the holidays. Or maybe, you are someone who is always coughing and clearing their throat?

A cough is a significant problem and one of the most common reasons for doctor visits.

A cough is a significant problem and one of the most common reasons for doctor visits. This time of year, many patients we see have had a cough or other upper respiratory illness, and for some, the cough can last longer than the original illness and become a long term, or chronic, issue. The impact from a chronic cough is not just from the discomfort and physical side effects of damage to you voice box. It may also have social cost from the embarrassment and impact on your quality of life and the financial costs from health-care visits, medications and lost productivity.

Coughing is an important reflex that helps prevent us from inhaling food or fluid into our lungs and eliminates infection from our lungs during an illness. The cough reflex is initiated from a sensation on the vocal cords that causes the vocal cords to shut and then compels us to exhale forcefully to clear out the airway.

Common causes of chronic cough include…

  • Asthma or chronic lung disease
  • Allergies, rhinitis or drainage from sinus disease
  • Gastroesophageal reflux disease
  • Medication side effects
  • Laryngeal hypersensitivity

Medical treatments of a cough caused by asthma, allergies and gastroesophageal reflux disease are typically effective. If you have a cough, see your doctor to rule out any lung, sinus or nasal disease. Review your current medications as some can cause a chronic cough and can be changed to improve your symptoms. It is possible to have a cough for up to 8 weeks after an upper respiratory illness that will resolve on its own. A cough is considered chronic if it lasts more than 8 weeks.

Patients with chronic cough may develop a heightened hypersensitivity in their voice box that predisposes them to cough more and may not completely resolve with medical management. The act of coughing requires the vocal cords to close traumatically, which induces further irritation and hypersensitivity, causing the cough reflex to be activated more easily.

Some chronic coughs do not respond to medical treatment can be treated effectively with specialized speech pathology intervention. This type of therapy assists patients by teaching strategies to inhibit, suppress, delay or interrupt a cough, as well as reduce the stimulation of a cough.

The ability to treat and control a chronic cough can be life changing. For more information or for evaluation of your chronic cough, consider visiting a specialist in laryngeal and voice disorders.

About the Author

Lindsey Arviso, MD, is a laryngologist on the medical staff at Baylor Scott & White The Voice Center. She has professional expertise in disorders of the voice, including surgical and rehabilitative voice needs. She has particular interest in treatment of vocal fold paralysis, benign and malignant vocal fold lesions, chronic cough and neurologic voice disorders. Dr. Arviso specializes in voice care for singers and other professional voice users. She is married with three children and enjoys traveling, Pilates and spending time with family and friends.

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